Individual
STEPHANIE JOLYN JANSMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2003 W FULTON ST, CHICAGO, IL 60612-2345
(312) 850-3438
Mailing address
18248 RIDGEWOOD AVE, LANSING, IL 60438-3024
(708) 805-9760
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.006552
IL
Other
Enumeration date
08/18/2015
Last updated
08/18/2015
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